Benefit Plans 

Vaya Health contracts with the North Carolina Department of Health and Human Services (NCDHHS) to manage benefit plans for Medicaid and State-funded services in our region. 

On July 1, 2024, we are launching Vaya Total Care, an NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plan, as part of North Carolina’s Medicaid Reform Section 1115 Demonstration. Vaya Total Care integrates physical and behavioral health care, pharmacy benefits, I/DD services, traumatic brain injury (TBI) services, and Long-term Services and Supports (LTSS) under a single plan. 

Under Vaya Total Care, we continue to manage NC Innovations Waiver services for individuals with I/DD under North Carolina’s 1915(c) Home- and Community-Based Services (HCBS) Waiver, as well as 1915(i) HCBS services. Learn more on our Vaya Total Care webpage. 

Vaya also manages an NC Medicaid Direct Prepaid Inpatient Health Plan (PIHP) that covers behavioral health, I/DD, and TBI services. NC Medicaid Direct is North Carolina’s health care program for beneficiaries who are not enrolled in NC Medicaid Managed Care. Learn more on our NC Medicaid Direct webpage. 

As part of the Tailored Plan, Vaya manages State-funded (non-Medicaid) services for mental health, substance use disorder, I/DD, and TBI. State-funded services are available to eligible residents of the Vaya region who are uninsured (or underinsured) and cannot afford care. Learn more on our State-funded Services webpage.